Plate-Screw and Stabilisation in Cervical Disc Herniation

ACDF (Anterior Cervical Discectomy and Fusion) is the most commonly performed technique in cervical disc herniation surgery.^1,2 The disc space is accessed through a small incision on the front of the neck, the herniated disc is removed, and a cage is inserted in its place, followed by stabilisation with a plate and screws.

Technical Details

The surgery is performed under general anaesthesia. The spine is accessed through a 3-4 cm horizontal incision in the neck, lateral to the oesophagus and trachea. Under microscope or loupe magnification, the disc space is completely cleared out. The nerve roots and spinal cord are decompressed. A bone graft or PEEK cage is placed into the space, and anterior plate and screw stabilisation is performed.

What is Fusion?

Fusion (union) is the merging of two vertebral bodies with bone tissue over time. The bone graft or bone growth factors inside the cage support this process. Complete fusion is usually achieved in 3-6 months.³ During this period, the use of a neck collar may be recommended to reduce pain and disability.⁴

The spine is accessed through a 3-4 cm horizontal incision in the neck, lateral to the oesophagus and trachea.

Results

The success rate for radiculopathy (arm pain) in ACDF is 90-95 percent.^5,6 Improvement in myelopathy symptoms depends on the duration and severity of the disease; early intervention yields better results.⁷

Adjacent Segment Disease

One of the known long-term issues of ACDF is adjacent segment degeneration. Increased mechanical loading on the discs above and below the fused levels can lead to degeneration at these levels over time. The annual rate of adjacent segment disease is approximately 3 percent.⁸

→ Next page: S24 — Cervical Artificial Disc